A5061364289- Diverticular Disease and Complications
- Anorectal Disease Treatments and Outcomes
- Inflammatory Bowel Disease
- Pelvic floor disorders treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Colorectal and Anal Carcinomas
- Appendicitis Diagnosis and Management
- Colorectal Cancer Surgical Treatments
- Patient-Provider Communication in Healthcare
- Surgical site infection prevention
- Pelvic and Acetabular Injuries
- Microscopic Colitis
- Hip and Femur Fractures
- Gastrointestinal disorders and treatments
- Surgical Sutures and Adhesives
- Global Health and Surgery
- Intestinal Malrotation and Obstruction Disorders
- Cancer survivorship and care
- Global Health Workforce Issues
- Clinical practice guidelines implementation
- Global Cancer Incidence and Screening
- Gastric Cancer Management and Outcomes
- Genetic factors in colorectal cancer
- Eosinophilic Esophagitis
- Amoebic Infections and Treatments
St Mark's Hospital
2020-2025
Imperial College London
2020-2025
University of Göttingen
2022
University of Birmingham
2022
National Institute for Health Research
2022
London Postgraduate Medical and Dental Education
2020
St Bartholomew's Hospital
2019
Derriford Hospital
2016-2018
University Hospitals Plymouth NHS Trust
2018
Abstract Aim The primary aim of the European Society Coloproctology (ESCP) Guideline Development Group (GDG) was to produce high‐quality, evidence‐based guidelines for management cryptoglandular anal fistula with input from a multidisciplinary group and using transparent, reproducible methodology. Methods Previously published methodology in guideline development by ESCP has been replicated this project. process followed requirements AGREE‐S tool kit. Six phases can be identified Phase one...
Abstract Pouch-related fistulae, such as pouch-anal and pouch-vaginal are serious complications that impact ⁓5% of patients undergoing ileoanal pouch surgery, frequently leading to failure. Research on treatment options is limited by small studies with inconsistent outcome reporting. To address this, the Pouch Anal Vaginal Fistula Core Outcome Set (PAVFCOS) was developed, identifying seven key outcomes through stakeholder consensus. This study aims create a core measurement set (PAVFCOMS)...
Perianal fistula mucinous adenocarcinoma (FMA) usually presents at an advanced stage, necessitating extensive surgical resection. Symptoms of perianal pain and discharge are indistinguishable from sepsis. Absence defined features on magnetic resonance imaging (MRI) precludes early diagnosis. This study aims to validate MRI that should increase suspicion transformation, prompting urgent examination targeted biopsies. Retrospective review studies was conducted in 9 patients with FMA Crohn's...
Acute cholecystitis has the potential to cause sepsis and death, particularly in patients with poor physiological reserve. The gold standard treatment of acute (cholecystectomy) is often not safe high-risk recourse made percutaneous cholecystostomy as either definite or temporizing measure. aim this study evaluate early late outcomes following treated at our institution.All who underwent for (excluding malignancy) between January 2005 September 2014 were included study.A total 53 (22 female,...
Abstract Aim Restorative proctocolectomy has been widely adopted as the procedure of choice for restoring gastrointestinal continuity following proctocolectomy. It is often associated with improved quality life and high patient satisfaction; however, development a pouch anal fistula can cause significant morbidity. Pouch fistulas are notoriously difficult to treat there great heterogeneity in management reported these fistulas. A lack classification, assumption that originating from...
Abstract Background Designing RCTs in surgery requires consideration of existing evidence, stakeholders' views and emerging interventions, to ensure that research questions are relevant patients, surgeons the health service. When there is uncertainty about RCT design, feasibility work recommended. This study aimed assess how could inform design a future pilot (Bluebelle, HTA - 12/200/04). Methods was prospective survey dressings used cover abdominal wounds. Surgical trainees from 25...
Perianal manifestations of Crohn’s disease constitute a distinct phenotype commonly affecting patients and conferring an increased risk disability burden. Much research has gone into management fistulising manifestations, with biological therapy changing the landscape treatment. In this article, we discuss up-to-date surgical medical perianal fistulas, highlighting current consensus guidelines evidence behind them, as well future directions in management.
No data are included in this letter.
Abstract Aim This study aimed to determine the clinical presentation, management and outcomes for patients with ileoanal pouch cancer. Method Patients who were diagnosed cancer identified from our polyposis registry (1978–2019) operative referral records (2006–2019). Details of endoscopic surveillance, staging retrieved hospital records. Results Eighteen (12 ulcerative colitis, one Crohn's disease, three familial adenomatous [FAP], two dual diagnosis FAP inflammatory bowel disease). The...
As well as inflammatory bowel disease, there are a number of other conditions which either predispose to or cause perianal disease. For the most part, these relatively simple and can be managed by local specialist but cases where more nuanced approach is needed tertiary referral maybe appropriate. In particular, rarer forms disease such complex cryptoglandular fistula, rectovaginal fistula (RVF) those associated with ileoanal pouches high levels morbidity, risk treatment failure. Experience...
Background Joint medical-surgical inflammatory bowel disease clinics allow simultaneous patient assessment by both a gastroenterologist and surgeon. However, perceptions of dual clinician presence have not been adequately assessed. Therefore, this study aimed to evaluate the patient's view receiving multidisciplinary care in clinic. Methods Patients attending clinic completed questionnaires assessing their attitudes towards clinic, overall satisfaction desired frequency appointments. Results...
Abstract Background Rectovaginal fistula (RVF) is a devastating complication of Crohn’s disease (CD). Despite advances in medical and surgical treatment, management CD RVF remains challenging. Surgery the principal treatment with adjunctive therapy. This study tracks patients from initial presentation through their pathways. Methods We reviewed our retrospective database (2009–2019). Patients were captured imaging coding. Outcomes included patient satisfaction, closure stoma reversal....
Abstract Background The development of peri-anal fistula mucinous adenocarcinoma (MA) is a presumed rare but recognised event in patients with fistulating Crohn’s disease. true incidence unknown, lack robust registry data. Fistula cancers may evade early diagnosis, presenting locally advanced intra-pelvic disease, necessitating debilitating and morbid exenterative surgery. Given the limitations endoluminal assessment this region context an often extra-luminal disease process, MRI studies...
Abstract Background Pouch vaginal fistulae (PVF) occur following restorative proctocolectomy with an incidence of 6%. The overall rate pouch failure is 10% but may be as high 29% a PVF. PVF can relatively asymptomatic, low volume mucus discharge alone, or cause considerable morbidity persistent, passive leakage faeces and gross perianal excoriation. Management challenging range reparative techniques reported no gold standard. Despite lack evidence, anti-TNF agents are increasingly used. It...
Jejunal diverticulae are a rare phenomenon that is usually asymptomatic but can present with chronic abdominal pain or as an acute abdomen when complicated by intestinal diverticulitis, obstruction, haemorrhage perforation. The clinical presentation often atypical and therefore diagnosis occurs at surgical intervention occasionally during imaging investigation. Surgical resection of the affected bowel segment primary anastomosis preferred treatment choice in jejunal diverticulosis.